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Thrush Symptoms and Treatment

Thrush is the common term for oral candidiasis. Other synonymous terms are “monilial”or “yeast” infections of the mouth. Thrush is a superficial infection of the mucous membranes of the mouth caused by the yeast Candida albicans. This yeast is ubiquitous and is a normal inhabitant of the mouth and vagina. It usually does not cause any problems.

Favorable conditions for growth of this yeast include illness, pregnancy and the recent use of antibiotics. Newborns come in contact with Candida during delivery. Greater than 30% of women have overgrowth of this yeast in their vagina during pregnancy.

Thrush appears as white patches in the mouth. The patches can be found on the lips, gums, inside of the cheeks, tongue, and roof of the mouth. If you attempt to remove these patches with your finger or a tissue, the area will bleed a little. The affected infant may have pain, irritability, and poor feeding. If there is white material only on the tongue, this is not likely to be thrush, this is from milk.

Thrush Treatment

Treatment must be initiated by your child’s doctor. A medication called nystatin is most often used. Nystatin suspension is used for thrush. You should place the nystatin on a clean finger and rub it directly onto the white patches four times a day until the infection is cleared. Fluconazole or gentian violet may be used if the thrush is not clearing with nystatin.

How to maximize treatment and prevent recurrences of thrush.

  • If nystatin is used, it is important that the medication be massaged into the affected area with the parents finger or a cotton swab. (Thorough hand washing before and after is important.)
  • Follow the prescription directions. For best results, treatment should be continued for 2 to 3 days after the thrush has disappeared.
  • During the course of treatment pacifiers and rubber nipples should be boiled once a day for 3 to 5 minutes. Intermittent boiling afterwards will keep exposure risk low.
  • Anytime pacifiers or toys fall on the ground they should be rinsed as thoroughly as allowable by the make-up of the object.
  • If breast feeding, keep breasts dry by using disposable nursing pads. Your child’s doctor may recommend topical application of an anti-yeast medication if your nipples are irritated.
  • Treat any concomitant yeast infection in the diaper area. Yeast infections in the diaper area are quite common. Candida albicans loves dark, warm, moist environments–a diaper. Change the diaper frequently. Treatment is usually with nystatin cream, powder, or ointment. Ointments tend to be better tolerated than creams because they will not cause burning when applied to the irritated skin. If the rash has been present for a while and it is quite red, it will be helpful to also use topical hydrocortisone 1% for a day or two. Other medications that can be used include miconazole (Monistat and others) and clotrimazole (Lotrimin, Mycelex and others).